DRG Quality Analyst IV – Healthcare

🕒 September 18

🇺🇸 United States – Remote

💵 $85k - $110k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 5%

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EXL

WebsiteLinkedInAll Job Openings

10,000+ employees

🏥 Healthcare

🛡️ Insurance

📦 Logistics

💰 $2M Venture Round on 2015-01

Healthcare • Insurance • Logistics

EXL is a business consulting and services firm that focuses on leveraging data to enhance business operations and decision-making. With a strong emphasis on collaboration and adaptability, EXL partners with organizations to address their unique needs and culture while integrating data science and technology solutions. The company's areas of expertise include operations management, decision analytics, digital transformation, and various industries such as healthcare, finance, and insurance. EXL's mission is to help clients drive business evolution and maintain competitive advantage through tailored solutions and effective use of data.

📋 Description

• Apply clinical judgment for DRG audits to ensure accuracy of inpatient DRG coding • Review the accuracy and consistency of clinical DRG auditors' work • Ensure audits are appropriately marked for findings and no findings • Mentor Clinical DRG auditors • Recommend process changes to improve quality and performance • Communicate with peers and management • Provide root cause analysis on errors • Perform other duties as assigned • Conduct job functions in accordance with company Compliance, Information Security, and Regulatory policies, procedures, and programs

🎯 Requirements

• Minimum 5 years of experience working with clinical validation audits • Active Coding Certification: CIC, CCS, CPC, RHIT, or RHIA • Superior auditing and monitoring skills • Ability to mentor and instruct • Excellent decision-making skills and sound judgment • Thorough understanding of medical terminology and human physiology • Strong technical knowledge and ability to learn new systems quickly • Excellent oral/presentation and written communication skills • Ability to complete tasks efficiently and resolve problems within set timelines • Strong organizational skills and attention to detail • Ability to work in a team environment and independently as needed • Demonstrated flexibility and adaptability • Must be able to work under deadlines and utilize independent decision-making skills in a wide variety of situations • Requires a high degree of accuracy in varied responsibilities • Personal computer skills required • Must be self-motivated to complete work in a timely manner and meet deadlines • Strong interpersonal skills required • A brief coding/auditing assessment may be included as part of the interview process

🏖️ Benefits

• Remote office opportunity / work from home • Benefits information provided at https://www.exlservice.com/us-careers-and-benefits

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